Transoral incisionless fundoplication with EsophyX® for treatment of gastro-oesphageal reflux disease

Gastro-oesphageal reflux disease results primarily from the loss of an effective antireflux barrier, which forms a mechanical barrier against the retrograde movement of gastric content. This review describes the technique of performing a transoral incisionless fundoplication with the EsophyX (R) device. Transoral incisionless fundoplication reconfigures the tissue so as to establish serosa-to-serosa plications which include the muscular layers, and construct 3-5 cm long valves 200-300 degrees in circumference. The steps of the technique, as well as complications and their management are described in detail, and a recent literature review is also provided. At present, available prospective cohort studies indicate that transoral incisionless fundoplication using the EsophyX (R) device may be effective in approximately half PPI-responsive gastro-oesphageal reflux disease for up to 3 years' follow-up, without troublesome procedure-related persistent side effects. (C) 2012 Editrice Gastroenterologica ltaliana S.r.l. Published by Elsevier Ltd. All rights reserved.